Need some advice.

[Tetrisaddict]

Hi all. I'm new here and I'd be grateful for some outside perspective on my issues.

I was diagnosed with GAD some years ago now and I've never really been able to get a handle on it. Initially my doctor prescribed anti-depressants, he said they also helped with anxiety. A few months later, and after many visits back to the same doctor, it was established that I also have something called Serotonin Syndrome. So SSRI anti-depressants were a no no.

But here comes the tricky bit.

I have an addictive personality. I have a history of drug abuse, and although I've been clean for 6 years, the doctor simply WILL NOT prescribe me anything that is habit forming/addictive. Which is incredibly frustrating because it limits the medications I can try. To give some perspective on this, last year I had a tooth extraction performed, the wound subsequently became infected and was very painful. The doctor told me to go and buy some otc paracetamol. I wanted some co-codamol because I knew it would be more effective. I even offered to have them put on a weekly, or even daily prescription so that I didn't abuse them. The doctor was having none of it.

I've had CBT, psychotherapy and standard counselling. Nothing works. I'm still anxious. Every single day.

What would people here do in my position? I have done some tentative research online re: anxiety meds, and I think I would benefit from diazepam, pregabalin, and some others. But, my doctor will not allow it.

What should I do?

[MyNameIsTerry]

Hi and welcome to NMP :welcome:

Serotonin Syndrome is a possible side effect of various antidepressants. Its on the rare side. It can be caused by switching between meds if doctors don't follow the correct protocols. It can be very serious and need emergency help. But its not a disorder, so once treated, its over. So, why are they saying SSRI's are a no go?

It can be tricky with doctors when there has been addiction. Pregabalin is already a difficult med to gey anyway and whilst it is not considered addictive, it is a drug that is used to enhance the effects of illegal drugs hence its got a black cloud hanging over it where even some GP's will deny it despite it being in the NICE guidelines as an option for GAD. So, it can take some forcing to get with some.

If your GP feels uncomfortable, have you checked the prescribing protocols for these meds to determine if there is NHS or NICE guidance that states they should not be prescribed to former substance misusers? I can't remember without checking.

What about a psychiatrist reviewing this situation? They can offer solutions that GP's are not allowed to.

[Tetrisaddict]

Hi and welcome to NMP :welcome:

Serotonin Syndrome is a possible side effect of various antidepressants. Its on the rare side. It can be caused by switching between meds if doctors don't follow the correct protocols. It can be very serious and need emergency help. But its not a disorder, so once treated, its over. So, why are they saying SSRI's are a no go?

He said that long term abuse of mdma can "permanently screw up" the brain's seratonin levels. Personally I've never heard of such a thing. It's akin to becoming permafried, which as I understand it is a myth. But this was his reasoning.


It can be tricky with doctors when there has been addiction. Pregabalin is already a difficult med to gey anyway and whilst it is not considered addictive, it is a drug that is used to enhance the effects of illegal drugs hence its got a black cloud hanging over it where even some GP's will deny it despite it being in the NICE guidelines as an option for GAD. So, it can take some forcing to get with some.

This is the crux of my problem. I had to disclose my past to my doctor, I thought it would safer to do so. But now, he just will not give me anything. And he seems to really hate that fact that I have looked a few things up and have asked for specific things. I am sure he thinks I am making stuff up, just to get hold of some drugs.


If your GP feels uncomfortable, have you checked the prescribing protocols for these meds to determine if there is NHS or NICE guidance that states they should not be prescribed to former substance misusers? I can't remember without checking.


Hmmm. I have not. But I definitely will now, thankyou. I'm still worried about what he will say though. It seems that he really hates it when I try to inform myself about things, instead of just following his instructions blindly.


What about a psychiatrist reviewing this situation? They can offer solutions that GP's are not allowed to.

I was recently discharged from my psychiatrist. I had a 1yr long course of psychotherapy, in that time I was taken off the psychiatrist's books, if I want to see him again I must be referred again by my gp, and the mental health system in my area works very slowly. It could be 6 months before I get to see him again.

I just want something I can take in the morning that will help me get through the day. My drug abuse days are definitely behind me - I just cannot seem to convince my doctor of this. In all honesty I'm thinking of asking to see someone different.

[MyNameIsTerry]

Some GP's can be like that. The days of "trust your GP blindly" are long over as patients have more access to information and, well, we see the failing standards in the media constantly so we have to thesedays.

If you mmake checks against NHS advice or NICE advice, it makes it harder for him to simply say no and he will have to explain things better. If he can't, maybe there is a problem there and a different GP would be for the best?

There are some studies about how MDMA could cause various impairments. I noted one shows shrinkage of the Hippocampus region of the brain. So, things like long term memory could be an issue there.

Serotonin Syndrome is because of having too much serotonin. MDMA causes serotonin to be used much quicker hence the after effects it can cause. If you can't retain enough brain serotonin (nearly all serotonin is in the gut and used for physical processes and will not cross the brain-blood barrier) then SSRI's will inhibit the loss ensuring more is retained.

So, how exactly has your brain changed to push out serotonin at higher levels? And where is there a credible clinical study that has been accepted by the NHS & NICE? If there isn't one, I would say this is a GP blagging.

I doubt you will get something to take to get you through the day as more constant daily medication is best, unless you mean things like propanalol, because they won't give out Benzo's other than short term unless it is a psychiatrist making the decision.

Personally, I would put him on the spot about where he gets this information from. It doesn't seem to be matching research articles online. Some later studies even debunk earlier ones so it doesn't seem like they really know at this stage.

[lindy lou 2]

Hi Terry, well my doctor has given me benzo's long term, ie diazapam, despite me always telling her they don't calm me ! I am so sick of taking tablets that don't work on me, and now having to try & withdraw from them all.

It is so worrying the way they are dished out, I worry about what the long term effects of it all will have on me.
I have been told by the p doc, that the risperidone will be the last thing I am tried on, no more anti d's. So they do seem to be tightening up on things, at last.
I am just scared that I will have to live with the anxiety forever.:weep:

[MyNameIsTerry]

Hi Lindy,

I know wht you mean. My GP is quite poor on his knowledge of these meds but he was firm on Diazapam. Yet he dished out a months worth of Zopiclone to then say he didn't want to give more despite telling me to take it daily! So, I had to have another weeks supply to do a "one day on, one day off" withdrawal from them. They did mess my sleep up, after initially helping, and it took months to get it back properly again.

Long term effects are very much a worry for us all. They simply don't know so I think we have to try to accept this as one of those issues outside of our control and move on because its unlikely we will be seeing anything for some years about it.